Lost in translation: The acute care nurse practitioners’ use of evidence based practice: A qualitative study

Abstract

Evidenced based practice (EBP) is a concept that has been widely enveloped by the health care industry. The benefits of EBP include cost savings, improved patient outcomes, and the translation of research findings to the bedside. In spite of the industry's acceptance of EBP, the literature is devoid of studies exploring the ways in which EBP is integrated into daily practice. This study used a qualitative approach to study the daily use of EBP by Acute Care Nurse Practitioners (ACNPs) which have far reaching implication for all health care providers who use EBP. A total of 10 practicing ACNPs from two large teaching and one community hospitals in a major, southern city in the United States, were interviewed. The transcripts were reviewed and thematic descriptors were identified. The ACNPs were overwhelmingly supportive of the use of EBP. EBP was the preferred method of delivering care, yet it was not regarded as a blanket prescription for care. A wide range of mitigating factors were identified, mandating careful consideration prior to applying EBP recommendations. The mitigating factors included: (1) beyond the barriers and balancing influencing factors, (2) to trust or not to trust, (3) balancing clinical knowledge and evidence in daily practice, (4) the patient is always right. In other words, balancing patient needs and desires often precluded the implementation of EBP tenets. This study's findings document the need for further study, improved instrument development, and educational initiatives that focus on the real world practice of integrating EBP among ACNPs and all health care providers.

Nurse Practitioners’ Implementation of Evidence‐Based Practice Into Routine Care: A Scoping Review

“…A qualitative study showed that participants recognized the value of EBP and believed EBP to be important for the standardization of clinical practice (Branham, DelloSritto, & Hilliard, 2014). In the same study, participants reported having skills in accessing, appraising, and applying up‐to‐date research evidence, in addition to being able to use clinical judgment, patient preference, and best evidence in determining patient treatment.…”

“…It was not possible to fully differentiate between EBP implementation at individual patient level and implementation into routine care (Butler, 2011; Roper, 2011; Singleton, 2017). Qualitative findings showed clear indications that NPs implemented EBP in caring for individual patients (Branham et al, 2014). The extent to which NPs implemented EBP into routine care was less clear.…”

Evidence-based practice utilization and associated factors among nurses working in Amhara Region Referral Hospitals, Ethiopia

“…Evidence-based practice positively influences the practice of nurses and enables them to shift from tradition to scientific-based practice [ 9 ]. Similarly, it results in reduced costs, improved patient outcomes, and serves as a standard for quality patient care [ 10 , 11 ], increases patient and family satisfaction, and contributes to professional development [ 8 ]. Again, it results in high job satisfaction [ 12 ], increases working efficiency, and reduces overtime [ 13 ], and fills the gap between theories and practice [ 14 ].…”

“…Despite having various positive effects on patient outcomes, nurses do not regularly utilize EBP [ 10 ]. The reason for this is that nurses face numerous challenges in converting evidence into practice [ 9 , 17 , 18 ].…”

Nurse-led versus doctor-led care for bronchiectasis

“…The Spanish guideline has identified some of the key nursing responsibilities, which include control of treatment adherence, assessment of medication tolerance, inhaled medication education, maintenance of equipment, intravenous antibiotic administration, disease monitoring with spirometry, and sputum clearance (Martinez-Garcia 2018). Introduction of guidelines for management assists nurses in advanced or extended practice roles to provide translational health care through integration of guidelines into current practice when clinically judged appropriate (Branham 2014). The costs of nurse training were also included among study expenses.…”